The Lead Episode 20: A Discussion of (RAPID): A Multicentre, Randomised Trial-The Lancet

The Lancet

Pdf Summary

A multicenter trial published in The Lancet examined the use of intranasal etripamil, a calcium-channel blocker, for the treatment of paroxysmal supraventricular tachycardia (PSVT). The study included 692 patients with a history of PSVT who self-administered etripamil or placebo outside of a healthcare setting.<br /><br />The primary outcome was the conversion of PSVT to normal sinus rhythm within 30 minutes. Etripamil was found to be superior to placebo, with a conversion rate of 64% compared to 31% in the placebo group. The median time to conversion was 17.2 minutes with etripamil and 53.5 minutes with placebo.<br /><br />Secondary endpoints showed that etripamil was associated with a lower rate of additional medical interventions and higher treatment satisfaction. The drug was well-tolerated, with no serious adverse events reported.<br /><br />The study suggests that intranasal etripamil can be safely and effectively used to convert PSVT to normal sinus rhythm. This has the potential to empower patients to treat PSVT episodes at home and reduce the need for additional medical interventions. However, more research is needed to evaluate the long-term efficacy and safety of etripamil in real-world settings.<br /><br />Overall, the RAPID trial demonstrates the efficacy and safety of intranasal etripamil for the rapid conversion of PSVT. The treatment regimen, which includes a repeat dose for persistent symptoms, shows promise in improving patient outcomes and reducing the burden on healthcare systems.

Keywords

multicenter trial

The Lancet

intranasal etripamil

calcium-channel blocker

paroxysmal supraventricular tachycardia

PSVT

self-administered

placebo

normal sinus rhythm

conversion rate